Individual
MRS. KATHRYN ANN KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
1924 TAPPAHANNOCK BLVD, TAPPAHANNOCK, VA 22560-9352
(804) 445-1015
(804) 445-1435
Mailing address
PO BOX 606, TAPPAHANNOCK, VA 22560-0606
(804) 445-1015
(804) 445-1435
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204143
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259468
BCBS PROVIDER ID
VA
Enumeration date
10/05/2005
Last updated
07/09/2007
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